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Kidney-specific proteins: markers for detection of renal dysfunction after cardiac surgery?

Nierenspezifische Proteine: Messparameter zur Entdeckung einer renalen Dysfunktion nach herzchirurgischen Eingriffen?

  • Published:
Clinical Research in Cardiology Supplements Aims and scope

Zusammenfassung

Herzchirurgische Patienten leiden nach kardiopulmonalem Bypass (CPB) häufig unter einer Beeinträchtigung der Nierenfunktion. Die Bewertung der Nierenfunktion stützt sich zumeist auf die Bestimmung der Urinausscheidung, des Serumkreatinins (sCrea) und der Kreatininclearance (CreaCl). Um mittels neuer Messparameter eine subklinische oder vorübergehende Beeinträchtigungen der Niere nach herzchirurgischen Eingriffen zu ermitteln, wurden nierenspezifische Proteine wie Neutrophil-Gelatinase-assoziiertes Lipocalin (NGAL), Neutral-Endopeptidase (NEP), Retinol-bindendes Protein (RBP), Alpha1-Mikroglobulin, N-Acetyl-Beta-D-Glucosaminidase oder Gluthation-STransferasen (GSTs) untersucht. Es zeigte sich, dass nierenspezifische Proteine ein nützliches Werkzeug zur Entdeckung einer Beeinträchtigung der Nierenfunktion sind und möglicherweise herkömmlichen Parametern zur Erfassung einer Nierendysfunktion überlegen sind. Zur Bestimmung des prädiktiven Werts der nierenspezifischen Proteine sind jedoch große kontrollierte Studien notwendig.

Summary

After cardiopulmonary bypass, cardiac surgery patients often suffer from renal injury. Clinicians rely on urine output, serum creatinine, and creatinine clearance as routine measures to evaluate renal function. Kidney-specific proteins such as neutrophil gelatinase-associated lipocalin (NGAL), neutral endopeptidase (NEP), retinol-binding protein (RBP), alpha1-microglobulin, N-acetyl-beta-D-glucosaminidase or gluthatione-S-transferases (GSTs) have been studied to define new measures to detect even subclinical or transient compromised renal integrity after cardiac surgery. It has been shown that kidney-specific proteins may be a useful tool for detecting impaired renal function in this situation, and may be superior to conventional renal function tests. Large controlled trials, however, will be necessary to determine the predictive value of kidneyspecific proteins.

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  1. Department of Anesthesiology and Intensive Care Medicine, Klinikum der Stadt Ludwigshafen, Bremserstr. 79, 67063, Ludwigshafen, Germany

    M. W. Wolf &  J. Boldt

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  1. M. W. Wolf
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Wolf, M.W., Boldt, J. Kidney-specific proteins: markers for detection of renal dysfunction after cardiac surgery?. Clin Res Cardiol Suppl 2 (Suppl 1), S103–S107 (2007). https://doi.org/10.1007/s11789-006-0043-8

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  • DOI: https://doi.org/10.1007/s11789-006-0043-8

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